Pathology report differences

[ordalesk]

Can anyone explain the differences in a pathology report? My original report came after my I/O, and then Dr. Jewett did a review of the pathology. Here is what each one found.


Tumor make up : Saskatoon Toronto

Embryonal Carcinoma : 80% 15%

Yolk Sac Tumour : 8% 70%

Teratoma : 10% 10%

Seminoma: 2% 5%

I expected minor differences, but not great amounts like shown in EC, and Yolk sac tumour. Any reasons why, and who is right in their assessment?

[Itsadeepbluesea]

I would go with a third opinion if possible to determine the tumor composition.

[Aegean]

Jewett more than likely used a GU Pathologist and since PMH is a recognized centre of excellence for TC, I would likely go with their findings. That being said, bring the differences up to Jewett through email. He or Donna will answer back asap. If you are not satisfied and want 2 out of 3 then ask you oncologist for a GU Pathologist in the Prairies.

[Fed]

Tumor make up : Saskatoon Toronto

Embryonal Carcinoma : 80% 15%

Yolk Sac Tumour : 8% 70%

These differences are quite major. What's more, these two cell types are very easy to distinguish from each other on a slide, so someone here is seriously wrong. That said, these major differences won't have an impact on the nature of the treatment. I do recommend that you get a third read to settle this.

[ordalesk]

Thanks Fed. I did wonder about the similarities or differences in the cells for identification. Even so, as trained pathologists reading the same group of slides, the differences should not be that great.

I emailed Dr. Jewett and all his reply was that it "may be sampling". Literally those 3 words.

That doesn't make sense to me as he had the same slides that the original pathologist used, so sampling shouldn't really be an issue to my way of thinking. I am going to speak with the original pathologist and see what he says and ask him about a third read.

I realize that it won't make a difference treatment choice wise, but I would like a defined answer on the pathology.

[MRMRSU]

Those differences are huge...and I agree with Fed that EC and yolk sac are not the kinds that would ever be confused with one another. I would want a third read on those slides without a doubt.

[ordalesk]

I spoke with the original pathologist and he says he completely defers to Dr. Jewett in the read of the pathology. He stated that he doesn't have a lot of experience with these tumors and relied on pathology texts for comparisons. In his opinion there are a lot of similarities in these two types of cells and that can account for the difference in the read. He seemed very glad that all the same types of cells were found to be the same and that he hadn't missed any of the components.

He was very nice about everything and offered for me to come into the path lab and look at the slides with him on a double microscope. I plan to do this for my next oncology appointment and find some of the cells online to learn about them and become familiar with their structure and appearance.

I am not going to have a third read done as I am going with Dr. Jewetts assessment of the tumour components and percentages. Either way, it makes no difference as I am taking the surveillance route.

As an aside to this thread, I had a good check up with the oncologist and my tumour markers were normal!

Darrin

[Smartie]

Hi Darrin.

Great news that your markers are normal. Congratulations.

Evidently you've pursued the question about the discrepancy with the path to a logical conclusion that you are satisfied with. I believe I too would not go to the effort of getting a third read in these circumstances.